PACS Certification Exam Question Bank | 110 Questions with 100% Correct Answers | Verified | Latest Update 2024
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Course
PACS Certification
Institution
PACS Certification
_______ processes are layers of testing that must be done before others. - step
What is documented in the patient medical records? -
• Laboratory and other studies are ordered as appropriate
• Working diagnoses that are consistent with findings
• Treatment plans that are consistent with ...
PACS Certification Exam Question Bank | 110 Questions with 100% Correct Answers | Verified | Latest Update 2024 _______ processes are layers of testing that must be done before others. - ✔✔step What is documented in the patient medical records? - ✔✔ • Laboratory and other studies are ordered as appropriate • Working diagnoses that are consistent with findings • Treatment plans that are consistent with diagnosis True or False: Biologics can be tiered to a lower tier that also contains other biologic products. - ✔✔True What staff members are not involved in processing a medication prior authorization request at an insurance company? Medical review officer, Pharmacist, Pharmacy technician, Veterinarian? - ✔✔Veterinarian Information needed to verify insurance eligibility: - ✔✔NPI number and insurance policy identification number Medical records may contain copies of: - ✔✔flouroscopy and MRI Authorizations are required: - ✔✔ • to save money • to determine proper utilization of medical services • to protect the patient Medicaid is: - ✔✔A coordination of health insurance benefits between the federal government and state government Most gap waivers cover the plan in network provisions of what is called the ______charges. - ✔✔customary Locations in which patients might receive outpatient infusion: - ✔✔• physician or provider's office • hospitals • infusion centers • home infusions Evaluation & Management (E&M) coding - ✔✔is defined as a process where a physician -patient encounter or appointment is translated into CPT codes for billing purposes Formulary exceptions are: - ✔✔requests that are for medications on the plan formulary but do not meet specific criteria When writing an appeal letter, you should include: - ✔✔• Your identification • The reason for the denial that they explained in the denial letter • The correct information ICD-10 codes - ✔✔Provide an alpha numeric reference for the diagnosis If a gap waiver is approved, ___________________________ - ✔✔Inform the patient, physician and scheduler A calendar year policy is from January 1 to December 31 - ✔✔True What is expected to happen as life expectancy trends upwards? - ✔✔• higher medication cost
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